An interesting article from "Oxford Today" magazine about a progressive Tibetan teacher who is teaching nuns and who presents mindfulness meditation as a science, not a religion which believes in God. Discussion with the leader of Oxford Mindfulness Centre about the practice of mindfulness which helps with depression and other problems of the modern life.

"Atheism creates a very impersonal cosmos. We humans yearn for a personal relationship, a direction. Yet secularism is collapsing into neo-paganism, largely because of the person-unfriendliness of secularism's machine-like world. But suppose the world were inherently personal, with persons as the primary ontological realities, not atoms, quarks, strings, etc."

POPPING PILLS FOR DEPRESSION:A BUDDHIST VIEWBy B. Alan WallaceThe whole of the Buddha’s teachings stems from compassion, the wish that all beings may be free from suffering and its causes. In today’s world, one of the most oppressive and debilitating kinds of suffering is depression. Far more than fleeting experiences of sadness, the clinically diagnosed mental disorder known as major depression is disabling in that it interferes with our ability to work, sleep, study, eat and enjoy once-pleasurable activities. The World Health Organization notes that mental ill health is increasing, and predicts that one in four persons will develop one or more mental disorders during their lives. By the year 2020, depression is expected to be the highest-ranking cause of disease in the developed world.In order to treat depression effectively, we must identify the specific causes and circumstances that contribute to individual cases. Otherwise, there is the danger that we may blindly treat its symptoms without addressing its underlying causes. According to recent studies, it seems highly unlikely that depression arises purely from chemical imbalances, except in rare cases of vitamin deficiencies, stroke and so on. Further, a synthesis of hundreds of studies indicates that antidepressants are no more effective in treating depression arising from these types of causes than in treating depression arising from stress-related causes. This implies that depression is best understood as a mental, not a neurological, disorder.I find it helpful to draw a distinction between these two kinds of disorders. Neurological disorders, such as autism, stem primarily from objective, biological factors, which in turn affect subjective experience. Mental disorders stem primarily from subjective mental processes, which in turn affect the brain. My underlying hypothesis here is that the mind and brain are causally interrelated but are not identical. Evidence suggests that depression is best understood as a mental disorder, so effective cures will be found by examining its principal psychological causes. This way of distinguishing between mental and neurological disorders helps to explain why our rapidly growing knowledge of the brain has not resulted in a corresponding degree of progress in developing drugs to treat mental diseases.According to Buddhist psychology, major depression is itself not regarded as a “mental affliction” (kilesa) per se but is rather a symptom of the underlying afflictions of craving, hostility and delusion. All mental afflictions are characterized by their quality of disrupting the balance of the mind, resulting in unwholesome behavior, which in turn gives rise to suffering for ourselves and others. Buddhist practice—comprised of the cultivation of ethics, samadhi and wisdom—is intended to remedy these true causes of human misery.If we look for the afflictive psychological processes within the Buddhist context that may result in depression, we may find that the so-called Five Hindrances, or “obscurations,” play a crucial role. These include (1) craving and attachment to hedonic pleasures, including those related to wealth, power and fame (resulting in chronic frustration and anxiety); (2) malevolence and resentment; (3) attention deficit and dullness; (4) attention hyperactivity and guilt; and (5) debilitating uncertainty. The Buddha declared that, “So long as these five obscurations are not abandoned, one considers himself as indebted, sick, in bonds, enslaved and lost in a desert track” (Sāmaññaphala Sutta). This is clearly a description of mental ill health, and it implies a fundamental, distinctive characteristic of the Buddhist worldview, namely that the mind of a person that is prone to all the above obscurations may be normal but it is not healthy.....http://www.inquiringmind.com/Articles/PoppingPills.html

Mental disorders stem primarily from subjective mental processes, which in turn affect the brain. My underlying hypothesis here is that the mind and brain are causally interrelated but are not identical. Evidence suggests that depression is best understood as a mental disorder, so effective cures will be found by examining its principal psychological causes. This way of distinguishing between mental and neurological disorders helps to explain why our rapidly growing knowledge of the brain has not resulted in a corresponding degree of progress in developing drugs to treat mental diseases.

I thought this guy is supposed to be a trained scientist, but it certainly is not evident from the "logic" displayed here. Some depression is very likely of psychological origin, but that is certainly not the case with all depressions. The idea that the "rapidly growing knowledge of the brain" should automatically lead to a corresponding degree is progress in developing drugs to treating mental illness is remarkably simplistic and ignorant. First of all the there has been an increased improvement of treatments for various mental illness over the years, but while we know so much more about the brain and its functioning than we did just 20 years ago, there is so much more that is yet to be known, as any good research scientist in this area would tell us. And that the fact that the drugs used to treat mental illnesses are not always effective does not ipso facto argue for Wallace's point of view, but it does point to the fact that science is still scratching the surface the brain's functioning/chemistry. The issues around the question of depression, the mind/body process, are far more complicated than Wallace is portraying them, and an article such as this does no real service to such a complicated and delicate issue as this.

This being is bound to samsara, kamma is his means for going beyond. -- SN I, 38.

“Of course it is happening inside your head, Harry, but why on earth should that mean that it is not real?” HPatDH p.723

>> Do you see a man wise[enlightened/ariya]in his own eyes? There is more hope for a fool than for him.<<-- Proverbs 26:12

Yes, I have to agree with you, Tilt.When I first read the article I was really quite shocked. I think its irresponsible for anyone to be offering advice with regards to mental illness unless they are a qualified medical scientist or practitioner and if its in relation to one's person's condition - if its a medical practitioner who knows the patient well.Perhaps he hasn't had up-close-and-personal experience as someone who has suffered from mental illness or close friends or family who have been debilitated by major depression, or seen the profound impact medical treatment often (but not always) brings to people's lives. Certainly, there is a role for Buddhist practice, particularly satipatthana, in being part of a raft of treatment. But advocating that drug-treatment is not efficacious or required is dangerous.kind regards,

Ben

“No lists of things to be done. The day providential to itself. The hour. There is no later. This is later. All things of grace and beauty such that one holds them to one's heart have a common provenance in pain. Their birth in grief and ashes.” - Cormac McCarthy, The Road

Learn this from the waters:in mountain clefts and chasms,loud gush the streamlets,but great rivers flow silently.- Sutta Nipata 3.725

I think Wallace is only repeating what many mainstrem scientsist are saying:

New generation anti-depressants have little clinical benefit for most patients, research suggests.

The University of Hull team reviewed published clinical trial data, and unpublished data secured under Freedom of Information legislation.

They found the drugs helped only a small group of the most severely depressed, and in most cases had no more effect than taking a dummy pill.

The Royal College of Psychiatrists said the findings were "very important".

In total, the Hull team, who published their findings in the journal PLoS Medicine, reviewed data on 47 clinical trials.

They focused on drugs in the class known as Selective Serotonin Reuptake Inhibitors (SSRIs), which work by increasing levels of the mood controlling chemical serotonin in the brain.

These included fluoxetine (Prozac), venlafaxine (Efexor) and paroxetine (Seroxat) - all commonly prescribed in the UK.

There seems little reason to prescribe anti-depressant medication to any but the most severely depressed patients Professor Irving KirschUniversity of Hull

The number of prescriptions for anti-depressants hit a record high in England in 2006 - even though official guidance stresses they should not be a first line treatment for mild depression.

The researchers found that even the positive effects seen on severely depressed patients were relatively small, and open to interpretation.

The seemingly good result came from the fact that these patients' response to the placebo decreased, rather than any notable increase in their response to anti-depressants.

Lead researcher Professor Irving Kirsch said: "The difference in improvement between patients taking placebos and patients taking anti-depressants is not very great.

"This means that depressed people can improve without chemical treatments.

"Given these results, there seems little reason to prescribe anti-depressant medication to any but the most severely depressed patients, unless alternative treatments have failed to provide a benefit."

'Small subset'

Professor Kirsch said the findings called into question the current system of reporting drug trials.

Dr Tim Kendall, deputy director of the Royal College of Psychiatrists Research Unit, has published research concluding that drug companies tend only to publish research which shows their products in a good light.

He said the Hull findings undermined confidence in the ability to draw meaningful conclusions about the merit of drugs based on published data alone.

He called for drug companies to be forced to publish all their data.

The National Institute for Health and Clinical Excellence (NICE) is currently reviewing its guidance on the use of antidepressants.

A spokesman for GlaxoSmithKline, which makes Seroxat, said the study only looked at a "small subset of the total data available".

And Eli Lilly, which makes Prozac, said that "extensive scientific and medical experience has demonstrated it is an effective anti-depressant".

Perhaps Wallace is repeating what some researchers are saying. I would hesitate to say that it is many. That is my reading - but I could be wrong.I wouldn't advocate a blanket approach of medical professionals proscribing medication for everyone with depression.What I do advocate is assessment and treatment tailored to the needs of the individual patient by a professional who is qualified to diagnose and treat the condition.kind regards,

Ben

“No lists of things to be done. The day providential to itself. The hour. There is no later. This is later. All things of grace and beauty such that one holds them to one's heart have a common provenance in pain. Their birth in grief and ashes.” - Cormac McCarthy, The Road

Learn this from the waters:in mountain clefts and chasms,loud gush the streamlets,but great rivers flow silently.- Sutta Nipata 3.725

Sigh, perhaps it's time for Wallace to review the literature on psychoneuroimmunology.

I suppose Wallace's strict dichotomy stems in part from the concern that the traditional distinction between "bodily" feelings versus "mental" feelings would be dissolved if the brain were allowed a role (no matter how minor) in the engendering of "mental" feelings. Underlying this concern might of course be the old kamma-rebirth bugbear - how is kamma from physical processes carried over in the mental process of rebecoming?